![]() ![]() The use of Computed Tomography (CT) results in better resolution and more precise localization, being the more accurate method for diagnosis and surgical planning. 1,5,7,16 A dental panoramic radiography usually shows the position and benign nature of the lesion. Radiographically, it appears as a unilateral, pedunculated, well-defined, oval or round mushroom-like radiopaque mass with similar density to normal bone. 6Ĭonventional radiological examinations (dental panoramic tomography and Water’ s view) are generally sufficient to diagnose an osteoma. The most common symptom when present is pain. ![]() 12,19 As in the present cases, peripheral osteoma are normally an incidental finding since they are asymptomatic, but other times depending on the location and the size of the lesion, it can cause facial deformity, deviation of the mandible on opening, headache, bone pain, dysphagia or exophthalmos. ![]() Peripheral osteoma of the jaw is an osteogenic benign lesion of slow growth, which can be or not pedunculated. 2,11,17 In current literature, there is only one case reported of osteoma in the zygomatic arch by Furnaleto et al. In the literature, case reports publishing osteomas in the mandible include 23 cases located in the body (4 cases in the anterior region and 19 cases in the posterior region) followed by the condyle (18 cases), angle (9 cases), ascending ramus (7 cases), coronoid process (5 cases) and sigmoid notch (1 case). 8,9,14 The involvement of the lingual surface of the mandible, such as in this present case, is uncommon. However, when it affects the jaws, the mandibular angle and the inferior border of the body are more commonly involved in association with the buccal plate. 5 Other documented locations include the external auditory canal, orbit, temporal bone and the pterygoid plates and, rarely, in or on the jaws. The most common site is the frontal sinus, followed by ethmoidal and maxillary sinuses. In the maxillofacial region, osteomas occur most frequently in the sinuses. Osteomas are more commonly found in the cortical plate of long bones such as the femur and the tibia. 7 They are more frequent in males than females (approximately 2:1). Osteomas in the maxillofacial region have been reported in patients between 29.4 and 40.5 years. 5 There are reports of cases varying from 16 to 74 years of age, with a mean age between 10 and 25 years. Osteomas can occur at any age, but are found most frequently in individuals older than 40 years. 12 Central osteomas arise from the endosteum, peripheral osteomas from the periosteum and extra-skeletal osteomas usually develops within a muscle. 1,2 There are three different types of osteomas: central, peripheral and extra-skeletal. Osteomas are benign, osteogenic lesions that may arise from proliferation of cancellous (trabeculae), compact bone (dense lamellae) or can be composed by a combination of both. Given that the patient was asymptomatic, treatment was not required. The panoramic radiograph demonstrated a unilateral, well-circumscribed, mushroom-like radiopacity located at the left angle of the mandible. The patient was completely asymptomatic with no history of previous facial trauma or contributory medical factors. ![]() The lesion was found incidentally in a dental panoramic tomography during routine evaluation for dental treatment ( Fig. Case reports Case 1Ī 57-year-old male patient was referred to the Department of Oral Radiology for evaluation of a radiopaque mass located on the left side of the mandible. The objective of this article is to present the radiographic features of two cases of osteomas, one in the lingual site of the mandibular angle and another one on the zygomatic arch. Osteomas can cause facial deformity, limitation or deviation of the mandible on opening, headache, bone pain, dysphagia or exophthalmos. Since osteoma is often detected incidentally on routine radiographic examination, the dentist should be aware of the features of this lesion. 1,5,8,10 In these cases, surgery is usually required. It is usually asymptomatic, and exhibit continuous growth at adulthood but it can grow into large sizes and cause facial asymmetry or severe dysfunction. 7,9 Osteomas are more commonly found in the cortical plate of long bones but they can also affect the maxillofacial region. 1–8 There are three different types of osteomas: central, peripheral and extra-skeletal. ![]()
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